Abstract

Worldwide trauma is currently the sixth leading cause of death, according to 10% of mortalities (1,2). Injury impact and the death from trauma are more common in males than females. People aged between 15 and 45 years include about half of the trauma deaths (3). Citizens of low- and middle-income countries ...
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Worldwide trauma is currently the sixth leading cause of death, according to 10% of mortalities (1,2). Injury impact and the death from trauma are more common in males than females. People aged between 15 and 45 years include about half of the trauma deaths (3). Citizens of low- and middle-income countries (LMICs) account for 89% of all deaths from trauma worldwide. This is particularly because of hospitals’ lack of facilities, equipments, and peripheral care systems (4,5).

Abstract

Objective: Trauma is one of the main causes of losing effective life among the populations. Knowing the pattern of trauma in each country can be considered as the first step in planning preventive programs to reduce trauma injuries. This study was conducted to evaluate the epidemiological status ...
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Objective: Trauma is one of the main causes of losing effective life among the populations. Knowing the pattern of trauma in each country can be considered as the first step in planning preventive programs to reduce trauma injuries. This study was conducted to evaluate the epidemiological status of trauma in Shahid Bahonar hospital in Kerman. Methods: This retrospective, descriptive cross-sectional study was conducted in 2014. The study population consisted of all traumatic patients who referred to Shahid Bahonar hospital. All patients entered the study based on census sampling. In order to collect data, the medical record of each patient was scrutinized and the demographic information, causes of trauma, and the anatomical location of trauma were extracted. All data were entered into the SPSS version 20 software. For data analysis, we used descriptive tests (frequency and mean) as well as analytical tests (chi-square). Results: 7803 (76.8%) traumatic patients were male and 2358 (23.2%) were female. Of all causes of trauma, accidents had the most frequency among women and men at 1208 (23.9%) and 3846 (76.1%) correspondingly. Other causes of trauma in both groups were related to falling (1538), violence (1720), occupation (1181), sports (663), and self-harm (5). The age group of 15-24 with 2576 patients had the highest amount of trauma (25.4%). In terms of location, limbs and thorax had the highest and the lowest amount of injury at 4527 (44.6%) and 653 (6.4%) respectively. We could observe a significant relationship between the cause of trauma with sex and the age variables (P < 0.0001). Conclusion: Males are more susceptible to traumatic problems than females regarding the nature of their jobs . Moreover, accidents are the main cause of trauma. Improving the quality of vehicles, roads safety, and establishing driver training courses to follow the rules are highly recommended.

Abstract

Objective: Most previous retrospective studies failed to show a consistent association between pre-hospital time intervals and mortality in trauma patients, bringing the recommendation of “transport fast to increase survival” under question. The aim of this study was to evaluate the association ...
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Objective: Most previous retrospective studies failed to show a consistent association between pre-hospital time intervals and mortality in trauma patients, bringing the recommendation of “transport fast to increase survival” under question. The aim of this study was to evaluate the association of response time, scene time, and transport time with 24-hour in-hospital mortality.Methods: In this cross-sectional study data were collected In the emergency department (ED). Time intervals were obtained from emergency medical service (EMS) central system. All traumatized patients presented to an urban academic hospital by EMS with Emergency Severity Index (ESI) levels 1 or 2 were included in the study. Exclusion criteria were age under 16 or above 65, being transported from outside of the city, severe underlying medical illness, life threatening intoxications, and randomized trauma score (RTS) of more than 10. Patients were followed in the hospital for 24-hour mortality.Results: A total of 2884 patients were enrolled in the study. Response time, scene time, transport time, and total out of hospital time were all associated with mortality in univariate analysis (P = 0.02, 0.01, <0.001, and 0.001, respectively). In multivariate regression analysis, transport time was associated with 24-hour mortality (P < 0.001, OR [95% CI]: 1.20 [1.16-1.24]).Conclusion: Although time intervals in most previous studies did not show association with mortality, there is no recommendation such as “pre-hospital time intervals in traumatized patients should not be limited,” since limiting time intervals for taking a traumatized patient to the hospital still seems to be prudent. Our findings support the recommendation of decreasing the transportation and total out of hospital time in the present condition in Kerman city EMS system.

Abstract

Objective: There are many communities at risk by a series of air pollution episodes. Tehran is one of the most polluted cities in the world. The presence of one or more air pollutants with a certain concentration in a particular period of time can cause several adverse effects on human and animals’ ...
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Objective: There are many communities at risk by a series of air pollution episodes. Tehran is one of the most polluted cities in the world. The presence of one or more air pollutants with a certain concentration in a particular period of time can cause several adverse effects on human and animals’ well-being that can cause much morbidity. There are several pollutants in the air but some of them can cause severe adverse effects on the lungs and air ways.Methods: In this retrospective cross-sectional study 1958 patients with exacerbation of chronic obstructive pulmonary disease (COPD) who were admitted in the emergency department (ED) of Rasol Akram hospital between March 2004 and March 2006 entered the study. Data such as number of admissions, air pollution particles (CO, SO2, O3, NO2, PM10) according to available documents were analyzed.Results: From 1958 patients who enrolled in this study, 887 (53.5%) were male and 771 (46.5%) were female. According to statistical analysis, we could observe a significant correlation between the concentration of Co, PM10, So2 with ED admission rate of COPD exacerbation (P: 0.031, 0.008, and 0.001 respectively). The effect of PM10, So2 and Co was more significant respectively in logistic regression on ED admission.Conclusion: There was significant correction between concentrations of air pollutants with number of ED admission for COPD exacerbation.

Abstract

Objective: To evaluate the association of base deficit (BD) with mortality in traumatized children, and to assess this association in a subgroup of patients with traumatic brain injury (TBI). Methods: In this cross-sectional study performed prospectively on a convenience sample of patients ...
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Objective: To evaluate the association of base deficit (BD) with mortality in traumatized children, and to assess this association in a subgroup of patients with traumatic brain injury (TBI). Methods: In this cross-sectional study performed prospectively on a convenience sample of patients under 16 years of age with trauma presenting to an academic level ІІ trauma center, we obtained venous BD values initially and followed the patients for in-hospital mortality. Initial vital signs were measured and injury severity score (ISS), randomized trauma score (RTS), and pediatric trauma score (PTS) were calculated. Results: A total of 102 patients were included, with 48 patients diagnosed with TBI. Nine patients (8.8%) died during admission, of which 6 were diagnosed with TBI. Based on the univariate analysis, BD was associated with mortality in the whole group (P = 0.01), but not in the TBI subgroup (P = 0.08). In multivariable analysis, RTS was the only variable independently associated with mortality (P = 0.001, odds ratio [OR] = 0.197). Linear regression model showed that BD was predictive of ISS, RTS, and PTS. Receiver operating characteristics (ROC) curve showed a cutoff point of -7 mmol/L for BD, below which there is a 12 fold increased risk for mortality. Conclusion: BD is a useful parameter in mortality prediction in pediatric trauma like in adult age group, but this predictive role in TBI patients is not supported by our results.

Abstract

Wasp sting is a relatively common arthropod assault. This usually results in pain and mild allergic reactions, but sometimes may cause severe systemic reaction and multiorgan dysfunction including rhabdomyolysis, hemolysis, coagulopathy, hepatic, renal and cardiac complications. Along with several ...
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Wasp sting is a relatively common arthropod assault. This usually results in pain and mild allergic reactions, but sometimes may cause severe systemic reaction and multiorgan dysfunction including rhabdomyolysis, hemolysis, coagulopathy, hepatic, renal and cardiac complications. Along with several other pathomechanisms, rhabdomyolysis is a distinguished cause of acute kidney injury (AKI) in patients with wasp sting. We herein report a case in which the patient developed rhabdomyolysis followed by AKI due to multiple wasp stings. The offending wasp was brought to the hospital and the species was confirmed by a zoologist (Vespa affinis).

Abstract

Cisplatin was the first of the platinum drugs. Second-generation platinum derivative was carboplatin that its efficacy in the treatment of many malignancies is equal to cisplatin, and its toxicity profile is more favorable. Here we report on a 50-year-old woman with a history of cervix cancer who developed ...
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Cisplatin was the first of the platinum drugs. Second-generation platinum derivative was carboplatin that its efficacy in the treatment of many malignancies is equal to cisplatin, and its toxicity profile is more favorable. Here we report on a 50-year-old woman with a history of cervix cancer who developed a severe hypersensitivity reaction (HSR) to carboplatin. She was admitted to the emergency department (ED) with shortness of breath, tachypnea, restless, agitation, and lethargy. On arrival, the patient was hemodynamically unstable; we initiated treatment immediately with hydration, oxygen therapy with mask, hydrocortisone, midazolam, and adrenalin. After 1 hour, BP and O2 sat improved to 100/70 mm Hg and 92% respectively, but there was not any significant improvement in tachycardia as well as tachypnea and she was still lethargic and agitated. Her symptoms improved gradually after 18 hours of admission. She was discharged after 36 hours. HSRs to cisplatin and carboplatin can be potentially life-threatening. The symptoms can range from a mild rash to severe anaphylaxis. Doctors should be aware of these reactions, determine appropriate treatment, and know the cross-reactivity among these drugs.